Take my hand – why pictures of hands have become the symbol of end-of-life care

Posted 19 December 2016byMatthew

by Laura Middleton-Green, WordPress, July 2015

Ms Middleton-Green is a doctoral student and the Marie Curie Clinical Academic Research Fellow in Palliative and End of Life Care at the University of Bradford.

In this post on her personal blog she ponders why “pictures of hands have become a ubiquitous symbol of end-of-life care. It seems that hands are increasingly becoming the standard representation of what it means to care for someone at the end of life.”

I recently completed 186 hours of observations of care of the dying in an acute hospital. It has surprised me that it is people’s hands, not necessarily their faces, that appear in my mind’s eye as I read through my field notes. One day I was struck by the remnants of silver sparkling nail varnish on a woman’s fingernails; I never met her awake, she died a few days after I arrived. As I sat, I found myself gazing at those hands, wondering about who had painted them, whether she was still awake and talking to them, how long it takes nail varnish to grow out. I saw wrinkled, liver-spotted hands, scrawny, emaciated hands, oedematous hands, long nails with unidentifiable grime caked beneath them, rheumatic gnarled hands, twisted out of shape, cold hands, warm hands, clammy hands, fingers that grasp at blankets, pluck at air, and wave away invisible imagined insects, clenched fists, trembling hands, palms turned upwards in surrender or clasped together in prayer.

Human contact of skin on skin is a profound means of connection in the absence of words or sense. To touch someone else’s hand is the essence of intersubjectivity – in touching, one is touched. There is a reason that we often call emotions “feelings”, rather than “sightings” or “sounds”, and this is the inextricable connection that can be made through touch.

I would favour touching a person’s hands over talking, and this is based on no evidence whatsoever, just an intuition that I have. Listening to words requires enough attention and concentration to discern the meanings of the words. Touch requires less in the way of interpretation; a comforting touch is a comforting touch. And if this touch is accompanied by a familiar voice then it doesn’t really matter what the voice is saying, the essence is that the dying person is not alone.